Active NPI
Jose Q Concepcion, MD
- Pediatrics Physician
- Brooklyn, NY
National Provider Identifier
1194796714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 145124
- Practice address
- 1620 E New York Ave
Howard Houses
Brooklyn, NY 11212-6861 - Phone
- (718) 385-3690
- NPI assigned
- Jan 31, 2006
- Last updated
- Sep 2, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 145124 | NY | Primary |
Addresses
Primary practice location
1620 E New York Ave
Howard Houses
Brooklyn, NY 11212-6861
Mailing address
137 Barlow Dr
Brooklyn, NY 11234
Phone (718) 763-1042
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00643370 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170117000351 | NY | Order and Referring Only - Pediatric Medicine | 3577721760 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 145124 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empress Ambulance Service LLC | Past | Accepting new patients | |
| Lifespire, Inc. | Past | Accepting new patients | |
| Lifespire, Inc. | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Ambulance
- Yonkers, NY
- NPI 1003878596
-
- Voluntary or Charitable Agency
- Hollis, NY
- NPI 1164629788
-
- Clinic/Center
- New York, NY
- NPI 1497709166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283385600000",
"number": "1194796714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 BARLOW DR",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11234",
"telephone_number": "718-763-1042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 E NEW YORK AVE",
"address_2": "HOWARD HOUSES",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112126861",
"telephone_number": "718-385-3690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONCEPCION",
"first_name": "JOSE",
"middle_name": "Q",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-31",
"last_updated": "2010-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "145124",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00643370",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.